Extracorporeal membrane oxygenation (ECMO)

Dr. Reza Poyanmore

Extracorporeal membrane oxygenation (ECMO) at the MHH and in referring Clinical Departments

Extracorporeal membrane oxygenation (ECMO) is an established procedure in modern intensive care therapy that works like a miniaturized heart-lung machine and can also be used outside the cardiac surgery operating theatre. ECMO takes over (partially or completely) the circulatory and respiratory function of patients whose lungs and/or hearts are severely damaged. A distinction is made between veno-venous ECMO (VV-ECMO, for patients with severe lung failure) and veno-arterial ECMO (VA-ECMO, for patients with advanced cardiovascular insufficiency). The number of ECMO patients at the MHH has increased continuously in recent years. Our mobile ECMO team is able to implant patients externally with ECMO for stabilization and thus make them transportable. The most common indications for ECMO implantation are summarized in the table. As many of these indications are emergency situations, it is often only possible to make provisional diagnoses and prognoses. However, these uncertainties in the diagnostic procedure do not rule out ECMO. Rather, it is crucial to generally include the possibility of ECMO in the treatment decision and then find the right time to implant such a mobile cardiovascular support system. Taking into account the current findings, the general clinical condition of the patient, the experience of the treating physician and the equipment of the Clinical Department in question, the following rule can be applied today: "The sooner, the better!".

Referring physicians can reach our ECMO team via the emergency number listed, with whom they can also clarify the possibility of external ECMO implantation in urgent cases. Once the indication has been established, the requirements for intensive medical care are checked and the availability of a suitable means of transportation is clarified. In cooperation with DRF Luftrettung and the Hanover Rescue Service, we then carry out the transports around the clock. An experienced team of cardiac surgeons and cardiotechnicians is available for ECMO transport operations. This ensures that the patient is cared for during the transport and enables successful further treatment at the MHH.

 

Possible indications for the use of ECMO

 

Pulmonary

  • Acute respiratory failure / ARDS
  • Pneumonia
  • Pulmonary arterial hypertension
  • Pulmonary embolism

 

Cardiac

  • Cardiogenic shock
  • Cardiomyopathy
  • Myocarditis

 

 

 

 

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